Jennifer Hibdon, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2016035083 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 268-4101

NPI assigned

Nov 22, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1790228872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102515",
            "telephone_number": "314-977-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBDON",
        "first_name": "JENNIFER",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2016035083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Katherine Hiatt-Jensen, FNP
• Barry Alan Hiatt, MD
• Sarah Hiatt
• Robert Boyd Hibbard, MD
• Peter Brunislaw Hibbeler, PHARMD.
• Stacey Marie Hibdon
• Christina Kim Ahn Hickey, MD
• Erin Margaret Hickey, MD
• Teal A Hickey, CRNA
• Scot G Hickman, MD

• Pediatric Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.